| Ormond Beach Dental Group | |
|
802a Sterthaus Ave Ormond Beach FL 32174-5132 | |
| (877) 676-6631 | |
| Not Available |
| Full Name | Ormond Beach Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 802a Sterthaus Ave, Ormond Beach, Florida |
| Authorized Official Name and Position | Kerri A Graham (OWNER/ DENTIST) |
| Authorized Official Contact | 8776766631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ormond Beach Dental Group 802a Sterthaus Ave Ormond Beach FL 32174-5132 Ph: (877) 676-6631 | Ormond Beach Dental Group 802a Sterthaus Ave Ormond Beach FL 32174-5132 Ph: (877) 676-6631 |
| NPI Number | 1124257175 |
|---|---|
| Provider Enumeration Date | 07/13/2009 |
| Last Update Date | 11/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124257175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN16350 (Florida) | Primary |
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Amanda Cobb, D.m.d., Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 785 W Granada Blvd, Suite 3, Ormond Beach, FL 32174 Phone: 386-672-6581 | |
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